The primary goal of this K23 proposal is to train Dean A. VanNasdale, Jr, OD as an independent clinician scientist. This training plan emphasizes mentoring in advanced retinal imaging, as well as advanced training in biostatistics and epidemiology. It will span 4 years of a Ph.D. program, followed by a 1-year post-doctoral training program. Concurrent with this, a 3-year MS program in Clinical Research will be completed. Included in the Retinal Disease Program set forth in the NEI's "National Plan for Eye and Vision Research" are goals emphasizing early detection and treatment of diabetic retinopathy and macular degeneration. Specific goals include improving early diagnosis of macular degeneration;understanding the pathogenesis of diabetic retinopathy and other vascular diseases of the retina;and developing strategies for primary prevention and improved treatment. Macular degeneration is a serious public health problem and the leading cause of blindness in the United States in adults, and increasing in frequency with advancing age. Diabetic retinopathy is also a significant public health problem in the United States, in the top three causes of vision loss. Early diagnosis will be necessary for the development of new treatment modalities;however, the ability to improve early diagnosis will depend on the capabilities of newer ophthalmic instruments that allow improved visualization of subtle changes taking place within the deeper structures of the retinal tissue. Improved imaging techniques will also be necessary to examine the pathogenesis of these diseases and to evaluate the efficacy of new therapeutic options. The long-term goal of this project is to use current ocular imaging technology, and design new imaging technology, to image the retinal and subretinal structure in patients with various stages of macular degeneration and diabetic retinopathy. This will facilitate identification and localization early retinal pathology that is currently not detectable by standard clinical methods. New therapeutic interventions emphasizing earlier treatment can be developed if better localization of retinal pathology can be assessed in earlier disease stages. This will lead to improved treatments that minimize vision loss in affected individuals.